Individual provider Active NPI

Tawfik A. Shabana, M.D.

  • General Practice Physician
  • Plano, TX
National Provider Identifier
1629496336
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
K4238 Issued in TX
Practice address
4317 High Mesa Dr
Plano, TX 75093
Phone
(214) 227-2625
NPI assigned
Mar 31, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K4238 TX
Pediatrics Physician 208000000X K4238 TX
General Practice Physician 208D00000X K4238 TX Primary

Addresses

Primary practice location

4317 High Mesa Dr
Plano, TX 75093

Mailing address

4317 High Mesa Dr
Plano, TX 75093
Phone (214) 227-2625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161025002122 CA Practitioner - Pediatric MedicinePractitioner - Internal Medicine 4082604715 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
79634CAMDMarriage & Family Therapist
K4238TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physician Affiliates Blue PLLC Current Accepting new patients
Texas Health Physician Affiliates Blue PLLC Current Accepting new patients
Southern Humboldt Community Healthcare District Current Accepting new patients
Southern Humboldt Community Healthcare District CurrentSince Sep 15, 2016 Accepting new patients
Southern Humboldt Community Healthcare District CurrentSince Sep 15, 2016 Accepting new patients
Permian Premier Health Services, Inc Past Accepting new patients
Texas Em-I Medical Services, PA Past Accepting new patients

Locations

733 Cedar St
Garberville, CA 95542
Phone (707) 923-3921

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1629496336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4317 HIGH MESA DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75093",
            "telephone_number": "214-227-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4317 HIGH MESA DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75093",
            "telephone_number": "214-227-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABANA",
        "first_name": "TAWFIK",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K4238",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K4238",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "K4238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.